Bladder preservation remains a viable option for certain patients with bladder cancer; with previous studies showing that patients up to the age of 84 can be safely treated with bladder preserving protocols, such as chemoradiation. Here, Alison Birtle, MRCP, FRCR, MD, of Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK, shares her thoughts on a case study involving the treatment of a patent with node-positive bladder cancer. She also provides evidence supporting the use of bladder preservation in patients with bladder cancer and shares her personal stance on the topic.